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Faculty Research Discussion Shines Spotlight on Veterans Concerns

April 30, 2013

by Loren Gary, Center for Public Leadership

A new gift to Harvard Kennedy School brought three Harvard faculty members together earlier this spring (March 11) for a small group discussion about research being conducted on the challenges facing returning veterans.

Cosponsored by the Center for Public Leadership and the Belfer Center for Science and International Affairs, the event was made possible by the John H. Adler Memorial Fund for Veterans’ Affairs. (Click here for the audio recording of the entire conversation.) Adler, a Harvard Law School graduate and former Congressman from New Jersey who died a year and a half ago, never served in the armed forces but was a strong advocate for veterans’ concerns throughout his political career. His widow, Shelley, also a Harvard Law graduate, established the fund in 2011.

“After every war, veterans need help,” said Kevin Ryan, director of the Belfer Center’s defense and intelligence projects, in his introductory remarks. “Sometimes their needs aren’t even recognized. After the urgency of a war it’s tough to get people to focus on veteran’s issues. That’s why the John H. Adler Memorial Fund for Veterans’ Affairs is so important.”

Shelley Adler, who attended the event with three of her sons, observed that her late husband came to realize that “the government’s response to the problems of veterans was often inadequate.” Medical schools study post-traumatic stress disorder (PTSD) and schools of public health study the effectiveness of hospital systems, she said, but the work is piecemeal—there is no interdisciplinary effort to link the various research initiatives. “The idea of the fund is to integrate this work.”

The first faculty presenter, Linda Bilmes, Daniel Patrick Moynihan Senior Lecturer in Public Policy at HKS, began by summarizing her research into the long-term costs of veterans’ medical care and disability benefits. These costs won’t peak until 2045, she noted; over the next 40 years they will total more than $1 trillion.

To date, more than 784,000 medical claims have been submitted by veterans who served in Iraq and Afghanistan, Bilmes continued. Of these, some 671,000 have been approved, at least in part. The average number of claims per person is eight. But the process for receiving, investigating, and approving claims is lugubrious, labor-intensive, and often takes two years—it’s an enormous cost, to say nothing of the time veterans must wait before they receive treatment. And the billions being spent annually on software to process the claims aren’t really solving the problem, Bilmes argued.

“We’re throwing away tons of money into a technology fix when the process itself is broken,” she said. A much more efficient process would be to accept all medical claims at the outset, she added, and to randomly audit claims so that fraud can be kept to a minimum.

Psychologist Richard McNally, who teaches in the Faculty of Arts and Sciences (FAS), spoke about the problems of PTSD and suicide. He noted that 4.3% of those who have served in Iraq and Afghanistan, and 7.5% of those who have been in direct combat, have developed PTSD. Combat stress is clearly linked to the onset of the disorder, but other issues are involved. For example, said McNally, nearly one-third of the Iraq and Afghanistan veterans who have committed suicide also had a major family relationship fall apart not long before.

But there is reason to believe that the war against PTSD is being won. Steps to identify and treat veterans at the greatest risk for PTSD earlier on are working, said McNally: “These treatments help move 60% of veterans out of the [clinical] diagnostic range.”

Cassandra Okechukwu, assistant professor of social and behavioral sciences at the School of Public Health, noted that although she and her colleagues had not yet studied veterans as an isolated group, many of the findings from the research she has conducted on blue-collar workers and immigrants are relevant to veterans. Among them: the way that the stress a parent experiences at work can have observable negative effects on the children at home, and the difficulty people have quitting smoking for good. “We need to take what we know and apply it to veterans,” Okechukwu declared.

Based at the Kennedy School, the Adler fund plans to make its first grant by the fall. Research initiatives, professors, and programs at all schools at the University are eligible; the preference is for research with direct policy implications.

Linda Bilmes, Daniel Moynihan Senior Lecturer in Public Policy, discusses her research on veterans' health care

“After every war, veterans need help,” said Kevin Ryan, director of the Belfer Center’s defense and intelligence projects, in his introductory remarks. “Sometimes their needs aren’t even recognized. After the urgency of a war it’s tough to get people to focus on veteran’s issues. That’s why the John H. Adler Memorial Fund for Veterans’ Affairs is so important.”